Organization Active NPI

McIntyre Family Chiropractic and Wellness Center

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1033309299
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006153 Issued in GA
Legal business name
MCINTYRE FAMILY CHIROPRACTIC AND WELLNESS CENTER
Practice address
1275 Powers Ferry Rd
Suite 300
Marietta, GA 30067-9486
Phone
(770) 952-9664
Fax
(770) 952-2962
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sean C. McIntyre, D.C.NPI 1245302306
Title
Owner
Phone
(770) 952-9664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 006153 GA Primary

Addresses

Primary practice location

1275 Powers Ferry Rd
Suite 300
Marietta, GA 30067-9486

Mailing address

1275 Powers Ferry Rd
Suite 300
Marietta, GA 30067-9486
Phone (770) 952-9664

Other identifiers 1

IdentifierTypeStateIssuer
GRP4899OtherMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000569 GA Part B Supplier - Clinic/Group Practice 4789581380 Receives reassigned benefits from 1 practitioner
Practice locations: Marietta, GA

National Provider Directory

National Provider Directory

Locations

1275 Powers Ferry Rd SE
Ste 300
Marietta, GA 30067
Phone (770) 952-9664

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1033309299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 POWERS FERRY RD",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300679486",
            "telephone_number": "770-952-9664",
            "fax_number": "770-952-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 POWERS FERRY RD",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300679486",
            "telephone_number": "770-952-9664",
            "fax_number": "770-952-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCINTYRE FAMILY CHIROPRACTIC AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-952-9664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "006153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GRP4899",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.